Immediate Pain Improvement Is a Useful Predictor of Long-Term Favorable Outcome after Percutaneous Laser Disc Decompression for Cervical Disc Herniation

Lee, Sang-Ho; Ahn, Yong; Choi, Won-Chul; Bhanot, Arun; Shin, Sang-Ha

doi:10.1089/pho.2006.24.508

Cited by 22 publications

(10 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Percutaneous laser disc decompression has also been used to treat cervical disc herniations with positive results; Lee et al [25] obtained a mean VAS pain reduction from a preoperative score of 7.9 to 2.6 at the final follow-up (mean Eur Spine J (2010) 19:477-486 483 71 months). These authors also treated 45 patients (47 levels) with contained cervical disc herniations via percutaneous endoscopic cervical annuloplasty [26].…”

Section: Discussionmentioning

confidence: 99%

Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial

Cesaroni

Nardi

2009

Eur Spine J

View full text Add to dashboard Cite

Prospective case series studies have shown that plasma disc decompression (PDD) using the COBLATION SpineWand device (ArthroCare Corporation, Austin, TX) is effective for decompressing the disc nucleus in symptomatic contained cervical disc herniations. This prospective, randomized controlled clinical trial was conducted to evaluate the clinical outcomes of percutaneous PDD as compared to conservative care (CC) through 1 year. Patients (n = 115) had neck/arm pain [50 on the visual analog scale (VAS) pain scale and had failed at least 30 days of failed CC. Patients were randomly assigned to receive either PDD (n = 62) or CC (n = 58). Clinical outcome was determined by VAS pain score, neck disability index (NDI) score, and SF-36 health survey, collected at 6 weeks, 3 months, 6 months, and 1 year. The PDD group had significantly lower VAS pain scores at all follow-up time points (PDD vs. CC: 6 weeks, -46.87 ± 2.71 vs. -15.26 ± 1.97; 3 months, -53.16 ± 2.74 vs. -30.45 ± 2.59; 6 months, -56.22 ± 2.63 vs. -40.26 ± 2.56; 1 year, -65.73 ± 2.24 vs. -36.45 ± 2.86; GEE, P \ 0.0001). PDD patients also had significant NDI score improvement over baseline when compared to CC patients at the 6 weeks (PDD vs. CC: -9.15 ± 1.06 vs. -4.61 ± 0.53, P \ 0.0001) and 1 year (PDD vs. CC: -16.70 ± 0.29 vs. -12.40 ± 1.26, P = 0.005) follow-ups. PDD patients showed statistically significant improvement over baseline in SF-36 physical component summary scores when compared to CC patients at 6 weeks and 1 year (PDD vs. CC: 8.86 ? 8.04 vs. 4.24 ± 3.79, P = 0.0004; 17.64 ± 10.37 vs. 10.50 ± 10.6, P = 0.0003, respectively). In patients who had neck/arm pain due to a contained cervical disc herniation, PDD was associated with significantly better clinical outcomes than a CC regimen. At 1 year, CC patients appeared to suffer a ''relapse, showing signs of decline in most measurements, whereas PDD patients showed continued stable improvement.

show abstract

Section: Discussionmentioning

confidence: 99%

Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial

Cesaroni

Nardi

2009

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…In contrast to open surgery, minimally invasive cervical procedures reduce these complications and become an alternative treatment for cervical HNP. In the last decade, a variety of minimally invasive procedures, including mechanical, chemical, and thermal/heat (radiofrequency and laser) methods, have been developed to decompress the discs in patients with cervical HNP [1617]. Knight et al [18] reported that cervical laser disc decompression produced and sustained significant clinical improvement in approximately 76% of cervical HNP patients throughout the period of 43 months.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Selective Focal Ablation by Navigable Percutaneous Disc Decompression Device in Patients With Cervical Herniated Nucleus Pulposus

et al. 2017

View full text Add to dashboard Cite

Objective To evaluate the clinical efficacy and safety following percutaneous disc decompression, using navigable disc decompression device for cervical herniated nucleus pulposus (HNP). Methods Twenty subjects diagnosed with cervical HNP and refractory to conservative management were enrolled for the study. The herniated discs were decompressed under fluoroscopic guidance, using radiofrequency ablation device with navigable wand. The sagittal and axial plain magnetic resonance images of the clinically significant herniated disc, decided the space between the herniated base and outline as the target area for ablation. Clinical outcome was determined by Numeric Rating Scale (NRS), Neck Disability Index (NDI), and Bodily Pain scale of Short Form-36 (SF-36 BP), assessed after 48 weeks. After the procedure, we structurally matched the magnetic resonance imaging (MRI) and C-arm images through bony markers. The wand position was defined as being ‘correct’ if the tip was placed within the target area of both AP and lateral views; if not, the position was stated as ‘incorrect’. Results The average NRS fell from 7 to 1 at 48 weeks post procedure (p<0.05). In addition, statistically significant improvement was noted in the NDI and SF-36BP (p<0.05). The location of the wand tip resulted in 16 correct and 4 incorrect placements. Post-48 weeks, 3 of the incorrect tip cases and 1 correct tip case showed unsuccessful outcomes. Conclusion The study demonstrated the promising results and safety of the procedure. Thus, focal plasma ablation of cervical HNP with navigable wand can be another effective treatment option.

show abstract

“…Other studies have reported similar results with respect to the durability of the surgical effect for endoscopic cervical discectomy. [2846]…”

Section: Discussionmentioning

confidence: 99%

Deuk Laser Disc Repair^®is a safe and effective treatment for symptomatic cervical disc disease

Deukmedjian¹,

Cutright²,

Cianciabella³

et al. 2013

Surg Neurol Int

View full text Add to dashboard Cite

Background:Deuk Laser Disc Repair® is a new full-endoscopic surgical procedure to repair symptomatic cervical disc disease.Methods:A prospective cohort of 66 consecutive patients underwent cervical Deuk Laser Disc Repair® for one (n = 21) or two adjacent (n = 45) symptomatic levels of cervical disc disease and were evaluated postoperatively for resolution of headache, neck pain, arm pain, and radicular symptoms. All patients were candidates for anterior cervical discectomy and fusion (ACDF) or arthroplasty. The Mann–Whitney Wilcoxon test was used to calculate P values.Results:All patients (n = 66) had significant improvement in preoperative symptoms with an average symptom resolution of 94.6%. Fifty percent (n = 33) had 100% resolution of all preoperative cervicogenic symptoms. Only 4.5% (n = 3) had less than 80% resolution of preoperative symptoms. Visual analog scale (VAS) significantly improved from 8.7 preoperatively to 0.5 postoperatively (P < 0.001) for the cohort. Average operative and recovery times were 57 and 52 minutes, respectively. There were no perioperative complications. Recurrent disc herniation occurred in one patient (1.5%). Average postoperative follow-up was 94 days and no significant intergroup difference in outcomes was observed (P = 0.111) in patients with <90 days (n = 52) or >90 days (n = 14, mean 319 days) follow-up. No significant difference in outcomes was observed (P = 0.774) for patients undergoing one or two level Deuk Laser Disc Repair®. Patients diagnosed with postoperative cervical facet syndrome did significantly worse (P < 0.001).Conclusion:Deuk Laser Disc Repair® is a safe and effective alternative to ACDF or arthroplasty for the treatment of one or two adjacent symptomatic cervical disc herniations with an overall success rate of 94.6%.

show abstract

Immediate Pain Improvement Is a Useful Predictor of Long-Term Favorable Outcome after Percutaneous Laser Disc Decompression for Cervical Disc Herniation

Abstract: The long-term clinical outcome of PLDD with LASE was fairly good, with a success rate of 85%. Immediate pain relief is a useful prognostic factor predicting favorable outcome following the procedure.

Cited by 22 publications

References 21 publications

Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial

Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial

Clinical Efficacy of Selective Focal Ablation by Navigable Percutaneous Disc Decompression Device in Patients With Cervical Herniated Nucleus Pulposus

Deuk Laser Disc Repair^®is a safe and effective treatment for symptomatic cervical disc disease

Contact Info

Product

Resources

About

Immediate Pain Improvement Is a Useful Predictor of Long-Term Favorable Outcome after Percutaneous Laser Disc Decompression for Cervical Disc Herniation

Abstract: The long-term clinical outcome of PLDD with LASE was fairly good, with a success rate of 85%. Immediate pain relief is a useful prognostic factor predicting favorable outcome following the procedure.

Cited by 22 publications

References 21 publications

Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial

Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial

Clinical Efficacy of Selective Focal Ablation by Navigable Percutaneous Disc Decompression Device in Patients With Cervical Herniated Nucleus Pulposus

Deuk Laser Disc Repair®is a safe and effective treatment for symptomatic cervical disc disease

Contact Info

Product

Resources

About

Deuk Laser Disc Repair^®is a safe and effective treatment for symptomatic cervical disc disease